Review highlights stronger myopia control with combination therapy

Combination therapy may offer better control of myopia progression than single-treatment approaches, particularly for patients with rapidly progressing disease, according to a recent review. Researchers found that combining optical treatments with atropine generally slowed axial elongation more effectively than monotherapy while remaining well-tolerated with minimal reported adverse effects.

Among the strategies reviewed, myopia control spectacles combined with atropine showed axial elongation rates of 0.05 to 0.28 mm per year, compared with 0.13 to 0.41 mm per year for monotherapy. Orthokeratology paired with atropine also provided added benefit, reducing axial elongation by an additional 0.09 to 0.29 mm compared with orthokeratology alone, with total reductions ranging from 0.19 to 0.48 mm over 12 to 24 months.

Evidence supporting multifocal contact lenses combined with atropine remains limited, while newer approaches such as light therapy and non-atropine pharmacologic agents used alongside optical strategies require further study.

The review noted that combination therapy may work by targeting multiple biological pathways, making it a promising option for improving myopia control in fast progressors. However, challenges such as treatment adherence, managing side effects, and higher costs may limit broader use

Reference
Thakur S, Han T, Bullimore MA, et al. Current Evidence on Options and Efficacy of Combination Therapy for Myopia Control-A Narrative Review. Ophthalmic Physiol Opt. 2026;doi: 10.1007/s44402-026-00071-x. Epub ahead of print. PMID: 41973380.